Consent Form
1. I hereby agree to comply with all the clauses specified in the Isolation Exemption Certificate that I have received.
2. In addition, I will thoroughly fulfill all my obligations of active monitoring, including COVID-19 testing at the airport upon arrival, installing the self-diagnosis app, answering every call from the Central Disaster Management Headquaters, and reporting symptoms.
I understand that providing false information on the application form for isolation exemption or failing to comply with the obligations of active monitoring will result in criminal punishment pursuant to the Infectious Disease Control and Prevention Act.
Date:
Applicant’s Name:
Signature:
To Ambassador in
210㎜×297㎜[중질지(80g/㎡)]
